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Instructor’s Manualfor

STRUCTURAL

FAMILY

THERAPYwith

HARRY APONTE, LCSW

Manual byAli Miller, MFT and Harry Aponte, LCSW

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STRUCTURAL FAMILY THERAPY WITH HARRY APONTE, LCSW

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The Instructor’s Manual accompanies the DVD Structural Family Therapy, with Harry Aponte, PhD (Institutional/Instructor’s Version). Video available at www.psychotherapy.net.

Copyright © 2010, Psychotherapy.net, LLC. All rights reserved.

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Teaching and Training: Instructors, training directors and facilitators using the Instructor’s Manual for the DVD Structural Family Therapy, with Harry Aponte, LCSW may reproduce parts of this manual in paper form for teaching and training purposes only. Otherwise, the text of this publication may not be reproduced, stored in a retrieval system, or transmitted in any form or by any means—electronic, mechanical, photocopying, recording or otherwise—without the prior written permission of the publisher, Psychotherapy.net. The DVD Structural Family Therapy, with Harry Aponte, LCSW (Institutional/Instructor’s Version) is licensed for group training and teaching purposes. Broadcasting or transmission of this video via satellite, Internet, video conferencing, streaming, distance learning courses or other means is prohibited without the prior written permission of the publisher.

Miller, Ali, MFT & Aponte, Harry, LCSW Instructor’s Manual for Structural Family Therapy, with Harry Aponte, LCSW

Cover design by Julie Giles

Order Information and Continuing Education Credits:For information on ordering and obtaining continuing education credits for this and other psychotherapy training videos, please visit us at www.psychotherapy.net or call 800-577-4762.

Instructor’s Manual for

STRUCTURAL FAMILY THERAPYWITH HARRY APONTE, LCSW

Table of ContentsTips for Making the Best Use of the DVD 4

Aponte’s Approach to Structural Family Therapy 6

Aponte’s Reflections on the Session 9

Reaction Paper Guide for Classrooms and Training 11

Related Websites, Videos and Further Readings 12

Discussion Questions 14

Role-Plays 17

Session Transcript 19

Video Credits 45

Earn Continuing Education Credits for Watching Videos 46

About the Contributors 47

More Psychotherapy.net Videos 49

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Tips for Making the Best Use of the DVD1. USE THE TRANSCRIPTSMake notes in the video Transcript for future reference; the next time you show the video you will have them available. Highlight or notate key moments in the video to better facilitate discussion during and after the video.

2. FACILITATE DISCUSSION Pause the video at different points to elicit viewers’ observations and reactions to the concepts presented. The Discussion Questions section provides ideas about key points that can stimulate rich discussions and learning. The Role-Plays section guides you through exercises you can assign to your students in the classroom or training session.

3.ENCOURAGE SHARING OF OPINIONSEncourage viewers to voice their opinions; no therapy is perfect! What are viewers’ impressions of what works and does not work in the sessions? We learn as much from our mistakes as our successes; it is crucial for students and therapists to develop the ability to effectively critique this work as well as their own.

4. SUGGEST READINGS TO ENRICH VIDEO MATERIALAssign readings from Related Websites, Videos and Further Reading prior to or after viewing.

5. ASSIGN A REACTION PAPERSee suggestions in Reaction Paper section.

6. WATCH THE EXPERTS SERIESThis video is one in a series portraying leading theories of psychotherapy and their application in work with families. Each video presents a master family therapist working with a real family who have real problems. By showing several of the videos in this Family Therapy with the Experts series, you can expose viewers to a variety of styles and approaches, allowing them an opportunity to see what fits best for them.

PERSPECTIVE ON VIDEOS AND THE PERSONALITY OF THE THERAPISTPsychotherapy portrayed in videos is less off-the-cuff than therapy in practice. Therapists may feel put on the spot to offer a good demonstration, and clients can be self-conscious in front of a camera. Therapists often move more quickly than they would in everyday practice to demonstrate a particular technique. Despite these factors, therapists and clients on video can engage in a realistic session that conveys a wealth of information not contained in books or therapy transcripts: body language, tone of voice, facial expression, rhythm of the interaction, quality of the alliance—all aspects of the therapeutic relationship that are unique to an interpersonal encounter. Psychotherapy is an intensely private matter. Unlike the training in other professions, students and practitioners rarely have an opportunity to see their mentors at work. But watching therapy on video is the next best thing.One more note: The personal style of therapists is often as important as their techniques and theories. Therapists are usually drawn to approaches that mesh well with their own personality. Thus, while we can certainly pick up ideas from master therapists, students and trainees must make the best use of relevant theory, technique and research that fits their own personal style and the needs of their clients.

PRIVACY AND CONFIDENTIALITY Because this video contains actual therapy sessions, please take care to protect the privacy and confidentiality of the clients who has courageously shared their personal life with us.

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Aponte’s Approach to Structural Family Therapy Structural family therapy is the only model I know that grew directly out of work with disadvantaged minority families. Back in the late sixties, Salvador Minuchin with his colleagues, including Braulio Montalvo, published Families of the Slums. In the book he described a model of therapy that was designed to address a distinctive feature of the most dysfunctional of these families, a family structure often characterized as disorganized or chaotic that presented the greatest challenge for therapists. I prefer to dub this structure “underorganized” because it describes families who lack the organization that is essential to effective functioning. There is often no clear parental leadership, no consistent roles with corresponding responsibility, and a pattern of communication that lacks the order necessary to be efficient and functional. Therapists needed to learn to recognize how the structure was not working and how to remedy it in order to be able to use their tools to be helpful to these families.

The model addressed aspects of family structure which have been variously named, and which I have boiled down to power (who habitually determines the outcome of family transactions), alignment (the coalitions and alliances in families), and boundaries (who is in or out of the various systems and subsystems in families, and their roles within these systems). I have also added the concept of values (culture, spirituality and morals) as an underlying organizing factor the gives human purpose to the functionality of structure.

Now, obviously these structural components are universal to all families, and are factors that need to be considered in working with all families. Consequently, the tools for dealing with these structures in families, I believe, cut across therapeutic models making for common factors. We deal with structure in the work with all families whether we recognize it or not, a common reality undergirding all social systems.

Some of the principal tools and approaches for working with family structure form the basis for common factors with other therapeutic models. There are seven principles of intervention that I particularly identify with the structural approach.

1. Focus on concrete issues: Structural therapists attempt to organize the therapy around specific issues that grab the family members’ attention and that contain within them the dynamics underlying a family’s core issues.

2. Locate the issue in the present: Without neglecting the historical antecedents that help us understand the present, therapists draw family members’ attention and energy to the issues as they manifest in the here-and-now.

3. Work through the family’s experience in session: Therapists look for access to the issues, their dynamics and the players through live experience in session, either in the enactment of issues among the family members themselves and/or between the therapist and the family.

4. Attend to the underlying structure: Whatever issues therapists work on and however they do so, they consistently attend to the family structure that needs building and repair to make possible lasting change.

5. Build on client strengths: Therapists generate the momentum for change by mobilizing the personal strengths of family members and the resources of their ecosystems throughout the actual and immediate therapeutic process.

6. Aim for palpable outcomes: Therapists manage the therapeutic process so that families see and experience positive change in and out of session, from small to greater successes, ever reinforcing the will to break new ground.

7. Engage actively and purposefully with families: Therapists “join” with families, actively connecting with them not only to gain their trust, but also to form relationships with them that are consciously tailored to promote the kind of change they, with the family, are pursuing.

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It is apparent that these approaches to change are common factors, explicitly or implicitly, contained in numerous other therapeutic models. Differences may well be in groupings of interventions and emphasis, if not just in language. It should also be understood that structural therapists do not limit their theoretical considerations and technical interventions to what we emphasize here. Structural family therapy can certainly be viewed from an integrative perspective that draws from the pool of wisdom of the field in general and of specific models of therapy in particular with the structural approach providing the integrating framework.

Aponte’s Reflections on the Session This was a single demonstration session for me with this family. I knew little about them before the session. Pam was obviously suffering from some developmental limitation that had not been identified for me. At the very start, body postures said so much about what was happening in the family. Judy, the mother, was staring straight ahead, alone and emotionally self-protective. Pam was sitting between her parents, looking at neither one, looking down much of the time with tension on either side. Adrian, the father, was sitting back watchfully, holding himself aloof from the entire process, but ready to pounce. This felt like a minefield. Judy was the first to volunteer what was her concern about Pam’s immaturity and her conflicted relationship with Judy. Both parents complained that the therapy they had received so far had not been helpful. Adrian, in particular, seemed skeptical. I had to make a connection with each one, and Judy was the first one to make herself accessible. The dynamics of the family soon became clear, and grew clearer as the session progressed. Pam appeared in a struggle with her mother who was expecting more of her than Pam was prepared to do. Adrian, who was retired, seemed to pamper her, keeping her close and in rivalry with Judy. Pam appeared dependent upon and enmeshed with her parents. She did not want to lose either parent, but found herself pleasing one parent while displeasing the other by being needy and dependent.The family lent itself to a structural approach, especially since Pam was not expressive verbally, at least initially. Eliciting some real live interaction between Pam and her mother drew out some of the dynamics and attendant emotions that were imbedded in their relationship. The interaction around something as simple and tangible as a weekend breakfast brought it all to the surface. We had an enactment that would give any therapist access to the family members’ issues with their emotions and thinking.Key to making things happen was the connection the therapist would make with the various family members. Judy needed to feel heard

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and validated about her frustration with Pam, but also her hurt. Pam, who deep down knew she was being a “spoiled brat,” needed to feel safe to fess up in the presence of both her parents without losing either one. Adrian needed to feel assured that his position of power and importance in the family was not being threatened even as he began to let go of Pam. Each needed to feel the therapist’s presence, understanding and acceptance even as they could envision how a shift in the structure of their relationships would give them what they wanted – a more mature Pam, while preserving and even deepening their affection and connections with each other in healthier ways.The arena of a pancake breakfast on the weekend was a safe enough environment in which to play out this drama. The dynamics were truly emblematic of what was happening between them, but innocuous enough that they could interact around it without anyone feeling threatened. The invitation to Pam to reach out and physically connect with each parent at the same time brought the work of the whole session to fruition in one live gesture – the bond of a love that kept them all safely connected, but in a freer and healthier way.

Reaction Paper for Classes and TrainingVideo: Structural Family Therapy with Harry J. Aponte, MSW, LCSW, LMFT• Assignment: Complete this reaction paper and return it by the

date noted by the facilitator.• SuggestionsforViewers: Take notes on these questions while

viewing the video and complete the reaction paper afterwards. Respond to each question below.

• LengthandStyle: 2-4 pages double-spaced. Be brief and concise. Do NOT provide a full synopsis of the video. This is meant to be a brief reaction paper that you write soon after watching the video—we want your ideas and reactions.

What to Write: Respond to the following questions in your reaction paper:1. Key points: What important points did you learn about Aponte’s

approach to Structural Family Therapy? What stands out to you about how Aponte works?

2. What I found most helpful: As a therapist, what was most beneficial to you about the model presented? What tools or perspectives did you find helpful and might you use in your own work? What challenged you to think about something in a new way?

3. What does not make sense: What principles/techniques/interventions did not make sense to you? Did anything push your buttons or bring about a sense of resistance in you, or just not fit with your own style of working?

4. HowIwoulddoitdifferently: What might you have done differently than Aponte in the sessions in the video? Be specific about what different approaches, interventions and techniques you might have applied.

5. Other Questions/Reactions: What questions or reactions did you have as you viewed the therapy sessions with Aponte? Other comments, thoughts or feelings?

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Related Websites, Videos and Further ReadingWEB RESOURCESHarry J. Aponte’s website www.harryjaponte.comPhiladelphia Child and Family Therapy Training Center www.princetonfamilycenter.orgMinuchin Center for Family Therapy www.minuchincenter.org

RELATED VIDEOS AVAILABLE AT WWW.PSYCHOTHERAPY.NET Bowenian Family Therapy, with Phil Guerin, MD (Note: features same fam-ily client as Aponte session)The Legacy of Unresolved Loss: a Family Systems Approach with Monica McGoldrick, LCSWTools and Techniques for Family Therapy by John Edwards, PhDFamily Secrets: Implications for Theory and Therapy by Evan Imber-Black, PhD

RECOMMENDED READINGSAponte, H.J. (1994). Bread and spirit: Therapy with the new poor. New York: Norton.

Aponte, H.J. Spirituality: The heart of therapy. Journal of family psychotherapy. 2002; 13(1/2), 13-27.

“Too many bosses”: An eco-structural intervention with a family and its community. Journal of strategic and systemic therapies. Fall, 1990; 9(3), 49-63.

Aponte, H.J. & Winter, J.E. (2000). The person and practice of the therapist: Treatment and training. In M. Baldwin (Ed.), (2nd ed.) The use of self in

therapy (pp. 127-165). New York: Hawthorne.

Aponte, H.J. (2009). Structural family therapy. In Albert R. Roberts (Ed.), (2nd ed.) Social workers’ desk reference (pp. 442-446). New York: Oxford.

Aponte, H.J. (2009). Structural family interventions. In Allie C. Kilpatrick & Thomas Holland (Eds.), (5th ed.) Working with families: An integrative model by level of need (pp. 117-128). Boston: Allyn & Bacon.

Aponte, H.J. (2009). The stresses of poverty and the comforts of spirituality. In F. Walsh (Ed.) (2nd ed.) Spiritual resources in family therapy (pp. 125-140). New York: Guilford.

Minuchin, P., Colapinto, J., & Minuchin, S. (2007). Working with families of the poor (2nd edition). New York: Guilford.

Minuchin, S. & Fishman, H.C. (1981). Family therapy techniques. Cambridge: President & Fellows of Harvard College.

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Discussion QuestionsProfessors, training directors and facilitators may use some or all of these discussion questions, depending on what aspects of the video are most relevant to the audience.

INTRODUCTION1. Paying attention to structure: What do you think about Aponte’s

emphasis on paying attention to structure in human relationships? Does that seem like an important part of family therapy to you? See if you can identify specific interventions in the session that indicate that Aponte is paying attention to structure (boundaries, alignment, and power). When you work with couples and families, in what ways do you pay attention to structure?

FAMILY THERAPY SESSION2. Mobilizing momentum: Aponte stated in the introduction

that his goal was to stay presently connected to the family and mobilize their momentum for change. Do you think he accomplished these tasks? What did you see him do that helped mobilize this family’s momentum for change?

3. Goals: How successful do you think Aponte was in moving this family towards achieving their goals of better communication and understanding Pam’s anger? What are some of the aspects of his approach that you think contributed to the family moving towards their goals? Is there anything you would have done differently to help this family improve their communication and create more understanding?

4. TherapeuticalliancewithPam: Aponte made various attempts to connect with Pam and to create an environment in which she felt safe enough to express herself. How successful do you think he was in making contact with her and creating a safe environment for her to come forward? Is there anything he did in particular that you think contributed to a sense of connection or safety? What might you have done to attempt to connect with her and help her feel safe?

5. Judy and Adrian: How would you describe the therapeutic alliance between Aponte and Judy? And how about his connection with Adrian? What specific interactions in the session do you think contributed to or detracted from the strength of the therapeutic alliance with each of the parents?

6. Eggs: What did you think of the dynamic between Adrian and Pam? In particular, what was your reaction to their interaction about one egg or two eggs? How might you have responded to them at that point in the session if you were the therapist? Aponte responded by saying, “Let’s get back to Mom and Pam.” Why do you think he redirected them in this way? What did you think of that intervention?

7. Boundaries and alliances: Would you have focused on the relationship between Pam and Judy to the same degree that Aponte did? Why or why not? What did you think of his decision to keep the focus primarily on the mother-daughter relationship and focus less on the other dyads in the family? What other alliances or subsystems in the family captured your attention? How might you have addressed these?

8. Spoiled: What do you think about the way Aponte worked with the family’s description of Pam as spoiled and Pam’s self-description as a spoiled brat? In what ways was this series of interventions helpful? If you had been this family’s therapist, how might you have worked with this issue?

9. Anger: Aponte’s hypothesis was that Pam’s anger was connected to her being spoiled and not getting her way. Do you agree with his hypothesis? What do you think are some other possible sources of Pam’s anger based on what you saw in this session? How do you imagine exploring the topic of Pam’s anger if you were the therapist in this session?

10. Afraidtogrowup: Aponte shared his hypothesis that Pam was afraid that if she started acting grown up, her parents would “just kick her out the door.” What did you think about the way he shared his hypothesis with the family? Do you agree with his guess? If not, what do you think might

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have been going on for Pam in relation to her parents? How might you have shared your hypothesis with this family?

11. Change: How did you react to Aponte’s instruction to Judy to stop spoiling Pam and to give Pam some control over their relationship? What did you like and dislike about his interventions with Judy in which he was encouraging her to respond differently to Pam? What else do you think might have supported a change in their dynamic?

12. Final scene: What was your reaction to the ending of the session, in which Aponte invited Pam to grab both her mom’s and dad’s hands at the same time? In what ways do you think this was a helpful or unhelpful intervention? Can you share any creative interventions you have made with your clients?

DISCUSSION13. Active vs. directive: Aponte characterized his style as active

and engaged as opposed to directive and controlling. Do you agree or disagree with his characterization? What, if anything, did you observe him do in the session that you would call directive? What do you think about his distinction?

14. Spirituality: Aponte stated that there is a fundamental spiritual similarity between himself and his clients, and that if he can connect with that then he can deal with any relative differences. How do you understand this remark, and does it make sense to you? What role, if any, does spirituality play for you in your work with clients?

15. The model: What are your overall thoughts about Aponte’s approach to family therapy? What aspects of his approach can you see yourself incorporating into your work? Are there some components of this approach that seem incompatible with how you work? What in particular would you do differently from Aponte?

16. Personal Reaction: How would you feel about having Aponte as your therapist? Do you think he could build a solid therapeutic alliance with you? Would he be effective with you? Why or why not?

Role PlaysAfter watching the video and reviewing Structural Family Therapy by Harry J. Aponte in this manual, assign groups to role-play a family therapy session following Aponte’s Structural Family Therapy model. Organize participants into groups of four, consisting of one psychotherapist and three family members. If time permits, rotate so each person has a chance to play the role of therapist.Rather than conducting a full session, invite participants to choose one segment of the session on the video to loosely reenact. The point here is not to try to resolve the family’s issues, but to use this role-play as an exercise in viewing the family from a structural framework and trying on Aponte’s style

INSTRUCTIONS FOR ROLE-PLAYERSOne person will start out as the therapist and the other three group members will decide amongst themselves who will be what family member. Choose a segment of the video that you would like to use as a basis for the role-play; do not attempt to follow the sequence of interactions, but rather use the clients and situation in the video as a jumping off point, and allow the role play to develop spontaneously. Therapists should focus on Aponte’s question, “What’s hurting these people?” and actively engage the family by focusing on issues that are of immediate concern to them.Therapists should pay attention to the underlying structure of the family, by focusing on power, alignment, boundaries, and values in the family. Who tends to determine the outcome of family transactions? What are the coalitions and alliances in the family? What are the subsystems in the family and what is each person’s role in the subsystem? What are the cultural and spiritual values of this family? After the role-plays, have the groups come together to discuss their experiences. What did participants observe about this family in terms of its structure? What did the therapist’s interventions elucidate about the family structure? Invite the clients to talk about what it was like to role-play this family and how they felt about the therapist’s

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interventions. Then, invite the therapists talk about their experiences; how did it feel to conduct a family therapy session using a structural approach? Finally, open up a general discussion of the strengths and the challenges in applying a structural approach to working with families. An alternative is to do this role-play in front of the whole group with one therapist and one family; the rest of the group can observe, acting as the advising team to the therapist. Before the end of the session, have the therapist take a break, get feedback from the observation team, and bring it back into the session with the family. Other observers might jump in if the therapist gets stuck. Follow up with a discussion on what participants learned about using Aponte’s structural approach to working with families.

Complete Transcript of Structural Family Therapy with Harry Aponte, LCSWHarry Aponte: You guys know this routine better than I do. I really know very little about you. They gave me very little information. I’d like to make this time work for you, be useful to you. So if you can tell me what you want to talk about, what you want us to look at, I will look at whatever you want to look at.

Aponte Commentary: The therapist begins the session by communicating that something good should result from this contact. This is characteristic of the structural posture toward therapy—each contact is an experience with the potential for change.

Judy: Well, you want to go or . . . ?

Adrian: No, go ahead.

Judy: We came because we wanted better communication with Pamela, and I don’t feel we’re getting that communication with her. Better self-esteem for her, and, just, you know, her to be more outgoing with us than she is at home. And I don’t think we are getting that, and we’re still not getting that from coming here.

Aponte: I see.

Judy: Because I don’t think anybody’s really interviewed her or really talked to her about a lot of things, or that.

Aponte: About . . .

Judy: About just anything in general or asking her why. I feel that she gets very angry with me a lot, and I don’t think we are getting this out of her as to why she is angry with me all the time.

Aponte: Pam?

Aponte Commentary: The therapist turns, and just voices Pam’s name to prompt her to react to her mother’s query as to why she is so angry with her “all the time.” This is the structural therapist’s move to promote

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an enactment, that is, an interaction in session that reflects the family’s interactions at home. It brings the issue with the family dynamics live into the session.

Pam: Not all the time. Most of the time.

Judy: Most of the time.

Judy: Yeah. Why I get so angry. Why I don’t talk. I don’t know. That’s what we are here to find out.

Aponte: What your mom is saying—it’s not just that you don’t talk, she is also saying that you get angry.

Pam: Yeah.

Aponte: At her.

Judy: Yeah. I don’t know.

Adrian: Well, not only at her. At anything. At anything. She could be playing a game, and she starts losing, she gets angry. I mean physically angry.

Aponte: When you say physically, Adrian, what’s . . .

Adrian: She’ll bang things, she’ll throw things. I don’t mean just sitting there saying, “Oh, damn it,” or something like that, you know. I mean she’ll physically get angry. She’ll beat on stuff, she’ll bang her hands, and everything else. She’ll go as far as to pull her hair.

Aponte: Pam?

Pam: No, I don’t pull my hair.

Adrian: Okay, the next time you do it I’ll remind you.

Pam: I’ll bang like, you know, the table or something.

Adrian: Or anything that’s around. It doesn’t matter if it’s fragile or not.

Aponte: What’s the matter, Pam?

Aponte Commentary: The therapist observes Pam rubbing her eyes, becoming more agitated. He brings attention to the signs of her upsetness in the moment. He looks to help her express herself, something she has

trouble doing at home. He also intends to intensify the experience for all in the moment.

Pam: Nothing.

Aponte: This is why we’re here. For you. Not for Mother, not for me.

Pam: I know. I know.

Judy: Why she gets angry with me a lot, too. No matter what I say to her, she gets angry with me.

Adrian: I’m retired. I’m home. She comes home from work. Usually everything is pretty good.

Aponte: Right.

Adrian: The minute she walks in the door, her attitude changes like pulling the shades.

Aponte: Why don’t we talk about that? You and your mom.

Pam: I don’t know I do it, but just instinctively do it. I don’t know.

Aponte: So, why don’t you remind Pam of some situation or something about which you guys get into it, so that we can begin exploring this.

Aponte Commentary: Again, the therapist looks for some tangible issue that will galvanize the family into action so that the drama of the family struggles at home can reemerge in the session.

Judy: What was it just recently? I’m trying to think.

Adrian: Just name something. You name something. Setting the table, feeding the dog.

Aponte: Right.

Adrian: She goes out and plays bingo. I say, “Go win me some money.” She gets angry.

Aponte: Okay, but are you guys saying that you, Pam, get more angry with your mom than you do with your dad?

Aponte Commentary: The therapist draws their attention to one aspect of the dynamic structure of the family, Pam’s greater anger toward mother than toward father, aligning with the father against the mother,

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which reflects her enmeshment with father. The therapist looks to trigger an interaction around this observation.

Pam: Yeah.

Adrian: You just name it, and the attitude just . . .

Judy: What was it Sunday? I asked her if she ate. We were at a party on Sunday. I asked her if she ate, and she said no. And then, so I just took it for granted that maybe she would go and eat something later. Maybe she wasn’t hungry. So I think we came home and I said something about her. I asked her if she finally did eat. And she says, “No, I told you no, I didn’t eat.” And she got angry with me right away. Oh, there was another incident too. There was a baby there, and she went to wipe the baby’s nose. And I told her how to wipe the baby’s nose instead of folding the Kleenex up into a little tiny piece and wiping his nose, she should have opened it up so she could wipe his nose at one time and then fold it over and rewipe it. And she got angry with me about that, and she said a few words underneath her breath, which I didn’t like in front of other people.

Judy: Well, that’s happening with Pam right now?

Pam: Nothing.

Aponte: I’m asking your mom to see if she understands what you are going through right now, because you seem to be really bothered.

Aponte Commentary: The therapist works to intensify the interaction in the here-and-now, while tilting the emphasis toward “understanding” rather than “accusing.”

Judy: Well, she’s crying again, and she does cry a lot. That’s another thing we are trying to figure out, why she’s crying.

Aponte: Why don’t you ask her what’s going on right now, what she’s feeling right now?

Judy: Pam, what do you feel now?

Pam: Nothing.

Judy: That’s what I get from her.

Adrian: What are you thinking about?

Judy: Nothing.

Adrian: Why are you crying?

Pam: I don’t know, I just do.

Judy: We can sit at the breakfast table and it will be the same thing. You ask her what she wants for breakfast, she doesn’t know.

Pam: Whatever.

Judy: So when I suggest the things, “I don’t know, whatever.” Well, you know, I can’t decide for her. Then if I don’t make her breakfast on Saturday or Sunday she gets angry with me. Her dad fixes her breakfast every morning, but you know, I don’t know what she wants, I’m not going to fix her something, or if we are all done eating and then she decides to get up, I’m not going to sit there and cook for her alone.

Aponte: But Pam, when your dad fixes breakfast you don’t have a problem?

Pam: Well, that’s because I’m going to work. I’m on my way to work. Hurry up and eat and go.

Aponte: But when your mom fixes breakfast on the weekend, go ahead.

Pam: She’s always making eggs, bacon and eggs.

Aponte: Right, go ahead.

Pam: Well, after a while you get tired of eating bacon and eggs all the time.

Adrian: Then why don’t you get tired of eating oatmeal every single day?

Pam: I don’t know.

Adrian: If you get tired of eating eggs once a week or twice a week, how come you eat oatmeal four or five days a week?

Pam: Well, that fills me up.

Aponte: What would you like on the weekend, Pam?

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Pam: Pancakes or French toast, or something else.

Aponte: Why don’t you ask your mom right now if she’ll make pancakes or French toast?

Pam: Hey, ma, would you like to make either French toast or pancakes or waffles or something on the weekend?

Judy: You know I do that every so often for you.

Pam: Or like, omelets or something?

Judy: What?

Pam: Omelets.

Adrian: What kind of omelet?

Judy: Wait a minute.

Pam: It doesn’t matter.

Judy: Omelets? You don’t like scrambled eggs.

Pam: Well, plain scrambled eggs.

Judy: But your eggs have to be burnt. How can you burn an omelet?

Adrian: Give it to daddy, he’ll burn it.

Aponte Commentary: The therapist privately notes that the father is ready to “spoil” Pam, putting dad on Pam’s side against mom who is resisting “spoiling” her. The structure of alliances is emerging all around something so mundane as “pancakes for breakfast.”


Judy: We do switch off with breakfast. I don’t always . . .

Aponte: Excuse me?

Judy: We do switch off with breakfast. I do ask her if she wants it, but I’m not going to cook it if she gets up after we’ve already eaten, to mix up pancakes or . . . I’ve made her French toast. But I think she’s old enough. She can make her own whenever she wants whatever. Especially after we’ve eaten and I’ve cleaned up the kitchen.

Aponte: I don’t understand. Pam, you’re saying to your mother that you’d rather she not make bacon and eggs, that you’d rather she make

pancakes or waffles or French toast, and Judy you’re saying, I think you’re saying that you don’t want to make that all the time, that you’d prefer to make the eggs and bacon. At least that’s what I’m figuring because you say occasionally you do make the other stuff.

Judy: Well, he prefers eggs and bacon. I don’t usually eat breakfast. So, I’m making one breakfast for him, and then I’m making one for her. If she’s there when we are eating, I don’t mind doing it for her, but if she gets up an hour after we’re done eating and I’ve got the kitchen almost cleaned up, for her to come in and say, well, she wants French toast or she wants pancakes or she wants waffles, well, there’s the stuff. Make it, then.

Aponte: What’s the problem then?

Judy: I don’t think she wants to do anything for herself.

Aponte: Pam?

Pam: That might be right.

Aponte: Do you cook?

Pam: A little bit. Not much.

Aponte: So you really depend on your folks to cook for you?

Pam: Mm-hmm.

Aponte: So, what do you think about what your mother just said?

Pam: It’s true. I just don’t want to.

Aponte: She said something else, Pam. She said that if you got up at the same time as they got up . . .

Pam: As they did. Yeah, she would make it.

Aponte: That she would be willing to do it, but she doesn’t want to have to clean up the kitchen and then start all over again with the pancakes and stuff.

Pam: Right.

Aponte: What do you think about that?

Pam: That’s true. Sometimes I do sleep a little later than they do.

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Aponte: Right. And . . .

Pam: And I should be able to do something for myself.

Aponte: Okay, but that’s not what I’m asking. You know your mother doesn’t want to prepare the pancakes. Let’s just talk about pancakes. You know she doesn’t want to prepare the pancakes, and she is already cleaning up. Why do you get angry at her at that point?

Pam: I don’t know. I don’t know.

Aponte: Is it because you still wish she would give you the pancakes?

Pam: Yeah, probably.

Aponte: You do know. But you are mad that she won’t. Is that right?

Pam: I guess.

Aponte: Don’t say you guess if you don’t mean it, now. I really want to know what you’re thinking.

Pam: I guess I do. I don’t know.

Aponte Commentary: Pam finally acknowledges why she becomes angry with her mother. The therapist has been working to create an environment that feels safe enough for Pam to speak candidly about the source of her anger with her mother, which is evolving into mother does not “spoil” her as her father does.

Aponte: And then when your mother says, “Well, prepare it for yourself,” what do you think about that?

Pam: I just don’t make anything then.

Aponte: Why not? Because you don’t want to cook?

Pam: Probably. I just don’t want to do it.

Aponte: Why don’t you like to cook?

Pam: I like to cook, but in the morning I’m not totally awake yet. I’d rather have someone that’s awake to do it.

Aponte: Okay, you and your mom come to some understanding. This is not mysterious now. You guys are understanding each other right now very well.

Aponte Commentary: The therapist punctuates a positive achievement, another characteristic of structural family therapy, which is to build on the positive, especially in the moment, hopefully generating some positive momentum in the mother/daughter’s experience of each other in the session.

Judy: Well, yeah. It’s not only this.

Aponte: Let’s not leave this though. I want to stay with this.

Judy: Okay.

Aponte: We’re getting somewhere here, you know. We’re understanding where she is coming from, and we are understanding where you are coming from, and I think you are understanding each other, the two of you right now. Okay? The question is, given that you are not going to cook pancakes if you are already cleaning up, and given, Pam, that you are not going to prepare the pancakes for yourself, okay, now what do you do with each other?

Adrian: She’ll stay home for a couple of hours, and then after that she will go out to the truck stop and get something to eat.

Pam: No, I don’t. Not on Saturday.

Aponte: What do you do?

Pam: Not on Saturday.

Aponte: What do you do on Saturday then?

Pam: I go clean the office, where she works at.

Aponte: No, but what do you do for breakfast then?

Pam: Nothing.

Aponte: You’d rather not eat, then?

Pam: Rather not.

Aponte: You’d rather not eat because you’re angry?

Pam: No.

Adrian: Because she has to do it herself. But yet what did we have for breakfast Wednesday?

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Aponte Commentary: The therapist notes in silence that the father is inserting himself just then, apparently attempting to pull Pam’s attention back toward him, away from mother.

Pam: This morning?

Adrian: This morning? Today’s Wednesday? Okay. She is off on Wednesday. What did we have for breakfast today, Pam?

Pam: I had to make it because . . .

Adrian: What did you make, Pam?

Pam: One egg, one piece of toast, and that was it.

Adrian: And what else?

Pam: No, that was it.

Adrian: Did you make another egg? Did you fry the second egg?

Pam: Only had one.

Adrian: I thought I smelled a second egg burning.

Pam: I only had one.

Adrian: I’m sorry. It took a while for it to come into the living room.

Aponte: Let’s get back to Mom and Pam. I wanted to see what happens with this thing. What’s the problem now? You understand each other. What’s the problem about breakfast?

Aponte Commentary: The therapist intervenes to reengage mom and Pam. The structural therapist actively works the dynamics of the family structure as it manifests itself in the session.

Pam: I just have to get up.

Aponte: No, you don’t want to get up early. If you don’t want to get up, why should you have to get up early.

Judy: I think I need help is what I need.

Aponte: What do you need help with?

Judy: With preparing the breakfast.

Aponte: What do you mean?

Judy: Helping get the breakfast ready. If she wants pancakes, then helping . . .

Aponte: Are you saying that even if you had already cooked and eaten that if she were to help you you’d go ahead . . .

Judy: Oh, I probably would, yes.

Adrian: She’s spoiled.

Aponte: Hold on, hold on. You may be right. Okay.

Aponte Commentary: The mother suddenly makes a positive shift, and offers a compromise. She will prepare the pancakes if Pam will help when she gets up late. The father also shifts as he joins his wife and the therapist by labeling Pam “spoiled.” The therapist acknowledges him, but will not allow that to draw Pam away from her engagement with mom.

Judy: She is.

Aponte: Okay, Judy, we are making good progress here.

Judy: If she would help, it would probably be . . .

Aponte: Pam, what about what your mother just said?

Pam: Huh?

Judy: I said if you would probably help me, you would probably get what you wanted. But when you tell me you don’t care or “I don’t know,” or “whatever,” I have no idea what that means. All I ask is for a decision to be made.

Aponte: Pam?

Pam: That’s true.

Aponte: Your mother has made an offer. She says if you help her, she will prepare the pancakes on Saturday. Even if you get up late.

Pam: No problem. We can do that.

Aponte: Judy? What does that mean? Your look in your eyes.

Judy: Well, no problem is the . . .

Aponte: You don’t believe her?

Judy: No, I don’t.

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Aponte: Pam, you heard your mother. She says she doesn’t believe you.

Pam: Which means I have to prove it to her.

Aponte Commentary: Pam moves to clinch the new agreement with her mother, which the therapist will try to firm up. But, then the mother reverts to her distrust of Pam, and father reverts to defending Pam. The therapist lets this play out a bit, and then steps back in blocking the parents’ old rivalry for power vis-à-vis Pam, and supporting Pam’s efforts in the session to speak for herself. He will reach out to her believing she is ready to own her own issue, and by doing so assume more ownership of her part in the family dynamics, a big step toward differentiation.

Aponte: Well, can you?

Pam: Yeah. I think I’m going to try to.

Judy: I mean, it’s just like after dinner. Well, she does help clean off the table after dinner. But then she walks out.

Pam: No, because I feed the dog first.

Judy: Well, all right, you feed the dog. But after dinner then it’s out the door she goes, or goes back into the computer, by the computer, and plays on the computer. She doesn’t help with the dishes or anything or say “Gee, Ma, I’ll do the dishes tonight for you,” or “Let’s take turns” or something. I get stuck with the dishes every night.

Adrian: I’ll have to interrupt you on that one. The other night she done all the dishes except for one pot.

Judy: She did. That was an exception.

Adrian: On rare occasions that she’ll wind up doing the dishes before Judy comes home.

Judy: I knew you would come up with that one.

Adrian: I have to, dear, because you are saying all the time.

Judy: Well, the majority of the time.

Adrian: It just happened yesterday or day before.

Judy: Yes, I knew that was going to come.

Adrian: So, you have to bring up the times that she does do it. Very,

very rare. But she does do it every so often, and she does it on her own. I don’t tell her.

Aponte: Let me get to sort of a core issue here. Pam, you agreed with both your folks that you are spoiled, okay? And apparently everybody knows it. Do you want to be spoiled?

Pam: Uh-uh.

Aponte: Because that’s why you get so angry, you know. You get angry when you don’t get your way.

Pam: Yeah.

Aponte: And if you’re spoiled, that means you’re accustomed to getting your way, and you want to get your way. And if you don’t get your way, you’re going to flip out.

Pam: Yeah.

Aponte: But you work, right?

Pam: Yeah.

Aponte: Where do you work?

Pam: At a grocery store.

Aponte: What do you do?

Pam: In the dairy department, stock.

Aponte: And are you a spoiled employee there?

Pam: Mm-mm.

Aponte: Because they don’t spoil you, right?

Pam: Right.

Aponte: So you are quite capable of not being a spoiled kid. Right?

Pam: Right.

Adrian: Very much so.

Aponte: So, I’m hearing little bits of information about you that says you are really quite capable of being an adult, a pretty responsible adult. Do you want your parents to help you not to be spoiled?

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Pam: Yeah.

Aponte: Because it’s got to be a miserable thing to be spoiled. Because you are constantly feeling angry because you are not getting your way, and you are going to be angry more times than you are going to be happy.

Pam: Mm-hmm.

Aponte: You want to ask them to help you to stop being spoiled?

Pam: Would you guys like to help me get not . . .

Adrian: How can I help you?


Adrian: How can I help you to stop getting angry?


Aponte: You know what, the question is “How can I help you to not give you your way?” Because being spoiled is a matter of getting your way, of having people doing stuff for you that you can do for yourself.

Pam: Right.

Aponte: And so that’s really the question. Where would they begin to help you to not get your way?

Pam: It can start anywhere.

Aponte: Pick one, Pam. Pick a good one for us. Come on.


Aponte: Something that you know. Let me tell you why I’m asking you this question. Pam?

Pam: I’m listening.

Aponte: The reason why I’m asking you this question is that you see, if they try to stop, to turn you around so you become a responsible adult and stop being spoiled, okay, you are going to fight it. The only way it’s going to work is if you want it, which means that you have to be the one to tell them, okay? “I don’t want to be spoiled.” Which then means you have to be the one to say, “I don’t you to give me my way about”

whatever. You have to pick what it is that you don’t them to give you your way. Even though it’s hard. Pick something.

Pam: Well, like four days a week, yeah, it’s nice that dad makes breakfast because I’m in a hurry to get to work. That’s fine.

Aponte: Okay.

Pam: Um, I don’t know where to begin. I mean there are so many things.

Aponte: Let’s talk about breakfast on the weekend then. What can they do not to spoil you?

Pam: Well, I don’t know. There are so many things.

Aponte: Is this very hard for you, Pam?

Pam: No, I just do this.

Aponte: You don’t just do this, Pam.

Pam: Yeah I do.

Aponte: You have real emotions going on there. I think this is very hard for you. I don’t think you know how to do this. Okay? Let me tell you something, an impression that I have, okay?

Adrian: Give her the Kleenex.

Aponte: Let me just get some facts from you, Judy. When Pam comes in and says, “I want pancakes,” and you guys have already finished basically, and she is not prepared to help, what’s your response?

Judy: I don’t think she comes in and tells me. She just says, “What are you making for breakfast?” Or if she sees that we are already done with breakfast--

Aponte: All right, what happens?

Judy: --then she gets angry.

Aponte: And then what do you do?

Judy: I either get up and walk out and just let her be. You know, if she wants to be angry, let her be angry. I mean, I just don’t feel I’m going to spend my whole morning in the kitchen cooking for her.

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Aponte: There is no question. She is asking you to help her with this. Pam? What can your mom do at that moment? You’re feeling angry because you wish she would just make you pancakes when you get there, and then you end up getting upset because she is not going to do it.

Pam: I just don’t eat, then. I’ll just have my cup of coffee and that’s it.

Aponte Commentary: Pam tries, but is becoming discouraged. We’re seeing how she retreats in the face of her mother’s frustration with her. The therapist jumps back in to prop up her positive efforts to change the dynamics between her and her parents.

Aponte: No, I want it to be nice for you. I want you to stop being spoiled. I want you to start growing up at home, but I want it to be in a way that makes you feel good. And right now it doesn’t feel so good. So, let’s think about it. Your parents just finished their breakfast. You got up. You love pancakes. You ask your mom. She doesn’t offer to make pancakes, and you know she is not going to make them, and you get angry. How can they help you?

Pam: They’d probably walk out and just let me sit there and have my cup of coffee.

Aponte: Do you want them to walk out and just leave you sitting there by yourself?

Pam: They usually do.

Aponte: What would you like for them to do?

Pam: Not for them, but for me to say “Hey Ma, come on. Let’s make the pancakes. I’ll help.”

Aponte: Why is that so hard for you to say?

Pam: I don’t know. But I just did.

Aponte: You just did. And you said it very well. You said exactly what you needed to say. (To the mother) How did that feel when she said it just now?

Aponte Commentary: This was a moment of triumph for Pam. In spite of her fear, she spoke up, and asserted that it was time for her to change

at home. The therapist validated her, solicited affirmation from Pam’s mother who has been her biggest critic.

Judy: It sounded good. Very heartwarming. Then there’s been days when I baked pancakes, and she doesn’t want them, so . . .

Aponte: Let me be very clear.

Judy: We don’t just eat bacon and eggs every day.

Aponte: I know that. I know that. You guys take very good care of this young woman. She’s got to do more.

Judy: For herself.

Aponte: For herself, okay?

Judy: Right.

Aponte: But she doesn’t want to grow up at home. She doesn’t mind growing up outside of home, but she doesn’t want to grow up at home. Okay? She wants to still be your baby, okay? Right? Okay. What I am suggesting to you is that you can show her how you can still be her mother, still take good care of her, and she can still grow up. That if she grows up, you are not just going to throw her out the door.

Judy: Well, that’s true. I mean we’re not pushing her out the door. I just want her to grow up.

Aponte: That’s all we’re talking about. I think she’s afraid that if she starts acting grown up you are just going to kick her out the door, and she’s scared to death. That’s my guess, okay? What happened just now was kind of tender. It was touching. I love the way she said it.

Judy: She did a good job of it, yes.

Aponte: She really did a nice job. What I am suggesting to you is that you, okay, is that you try to control your temper and anger when she provokes you. But listen, never make the pancakes for her unless she offers to help. That way you stop spoiling her. But then you say to her, “Do you want to help? I’ll be glad to make them.” It’s even better if she herself initiates it and says, “I’d like to have pancakes. I’ll help.” Can you do that?

Judy: Well, I can try.

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Aponte: What’s happening to you right now, Judy? What’s the emotion about?

Judy: I want to try.

Aponte Commentary: This is a tender moment.

Judy: Okay. This is a loving thing that can go on between the two of you, but it will be hard because she’s scared. This is not an angry, defiant person who doesn’t care. This is a person who is very scared to grow up. She needs a mother who is not going to do it for her but a mother who says, “If you’re willing to do it, to help, I’ll do it with you. I won’t do it for you.”

Judy: Right.

Aponte: About more and more things at home.

Adrian: And that only doesn’t mean making them, that means help cleaning up afterwards.

Aponte: Absolutely. Something that says, “Pam, you are not going to leave the table and go to your computer. If you want dinner here in our house, I have to know that you are going to help clean up. Otherwise I don’t want you sitting at the table. You’re not a baby.”

Judy: Well, that’s it.

Aponte: But we have to find out whether she wants that. Pam? If your mom were to say that to you, would you want her to say it to you?

Pam: Well, not about the “you’re not going to eat at the table.” No, I will eat. But I have to help wipe dishes and stuff.

Aponte: If your mom says, “From now on I need for you to help me clean up,” would you want her to say that to you?

Pam: Mm-hmm.

Aponte: And what if you didn’t feel like it?

Pam: Then I would still have to do it anyway.

Aponte Commentary: Even as the therapist helps firm up the parents’ new posture toward Pam, he offers Pam a chance to assert her resolve to work with her parents, to grow up vis-à-vis them. She takes it.

Aponte: She can’t force you to do it, Pam. You are only going to do it if you want to grow up.

Pam: Right. That’s what I meant.

Aponte: Okay. Because, see, what I’m saying to your mother is frankly that, I’d say to her that the day that you said “I don’t want to help” I’d say to her, “Tomorrow don’t come sitting at this table if you are not going to be helping. I need for you to be a grownup person, but if you don’t want to you don’t have to be. But just prepare your own meals.” That’s what I’d tell your mother to do. But what I would rather see happen is for you to say, “Okay mom. I don’t really feel like doing it. I’d rather be a baby, but I am going to help clean up the dishes because that’s what I want. I don’t want to live my life angry all the time and frustrated all the time.”

Judy: I’d enjoy having her either helping me with the dishes even if she had to wipe them and standing there talking to me, or doing something instead of me being alone in the kitchen and doing the dishes alone.

Aponte: Do you love her?

Pam: Oh, yes.

Aponte: You really do?

Judy: Very much so.

Aponte Commentary: The therapist goes for the mother’s affect, deepening the intensity of the experience for everyone in the room at that moment.

Aponte: I thought you did. I thought you did. So I think what’s happening, you know, in your relationship is that you are losing the opportunity to be affectionate with your daughter. There is too much fighting going on.

Judy: I just walk away.

Aponte: I know. But there is a lot of anger.

Judy: There’s too much anger.

Aponte: Yeah. Right.

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Judy: Because no matter what I say, she gets angry with it. If I tell her her blouse is on crooked she gets angry. I mean, if her blouse is crooked. I’m just saying that as an example, but I mean just simple things. She gets angry with me.

Aponte: But, do you know what you have to say to her? She gets angry or something like that you ask her a question. Say, “Pam, do you want me to tell you when your blouse is crooked or not? Because if you don’t want me to, I won’t, and if you look bad, I will not tell you, but I’m not going to tell you unless you want me to.”

Judy: There is sometimes, with the hair, “I’ll say go comb your hair.” “Well I’ve already done that.” I’ll say, “Well it doesn’t look that great.”

Aponte: I would say to her, “Pam, do you want me to tell you about your hair? Because I have something to say about it, but if you don’t want me to I will not.” So that Pam knows that if she wants a mother, she has to say, “Yes I want you to tell me.” Because that’s your chance to be a mother to her, to take care of her. Okay? And if she says, “I don’t want you to tell me,” then you say “I won’t,” which means then she loses that little bit of your being a mother. You are going to feel bad because you won’t have the chance to take care of your daughter, but she is going to feel bad. But you’ve got to make her feel what she just did. In other words, give her some control over her life. Give her some control over the relationship with you. So if she wants you, she’s got to invite you in. If she doesn’t invite you in, you don’t go in.

Aponte Commentary: The therapist is working to disentangle the enmeshment in the family, now between mother and daughter. He does so by trying to establish more independent control by members for his/herself in their interactions with each other.

Judy: Well, that’s it. I just . . .

Aponte: You don’t just walk away. I’m saying to you, you say it to her. “Pam, do you want me to comment on your hair? Do you want me to comment on your blouse? Pam, do you want to sit at dinner with us? Because if you do, you need to clean up. If you want me to comment on your hair, I will, but I need to know that you definitely want me to comment on it.” So that each time she has to make the decision

whether she wants to be a grown-up or a spoiled kid.

Judy: Okay.

Aponte: And every time she decides she wants to be a spoiled kid, she is going to lose a little bit of her mother, because her mother will not get involved.

Judy: We’ll have to try this one.

Aponte: Doesn’t that sound good, Pam?

Pam: Yeah. I like this idea.

Aponte: See, because she will be giving you the chance to decide whether you want to be a spoiled kid.

Pam: Not a spoiled kid, a spoiled brat.

Adrian: A spoiled brat. I like that. That’s good. I like that, Pam. She will be giving you a chance to decide whether you want to be a spoiled brat or an adult woman. And the more you are an adult woman, the more you will have your mother. But you are going to have to be consistent, Judy.

Pam: Yes. So am I.

Judy: We’ll give it a try and we’ll see what happens with it now.

Aponte: Judy, don’t give it a try. This will work if you stay with it. Now, what I don’t know is, well, Adrian here who spoils her in his own way, because he is spoiling her on the one hand, and you try to do this on the other side, it is not going to work.

Aponte Commentary: Now comes what for the therapist was the most challenging part of the session, dealing directly with the father’s enmeshment with Pam, and rivalry with the mother for Pam’s affection. In the little time that is left, the therapist must reach out to the father, let him tell his side of the story, and then connect with him while also challenging him to change his relation ship with both daughter and wife. The therapist is asking him to join the mother in the parental system, and parent Pam with his wife.

Adrian: Tell him how I spoil her.

Judy: Well, he gets up every morning with her.

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Adrian: Oh, yeah. I’m making the breakfast and making her lunch for her.

Judy: I think that’s spoiling her.

Adrian: Oh, you think so?

Pam: No, that’s helping me get out of the house.

Adrian: That’s shoving her off to work, dear.

Judy: She’ll work with him more than she will with me. She’ll do things with him, but she doesn’t care to do them with me.

Aponte: Why is that, Adrian?

Adrian: I don’t know. I don’t know. Now ask me who’s rough on her.

Aponte: You are.

Adrian: You better believe it.

Aponte: But see, I think that’s why.

Adrian: She’ll come up to me and give me hugs all over the place. I don’t know if I should say it in front of her or not, but she’s a lady, so. I think she resents Judy as a woman coming in to me when Judy comes home to me. She comes home to us, but she comes home to me.

Aponte: How does that sound, Pam?

Adrian: And I think she resents her as a woman to woman.

Aponte: I hear you. I think that’s good. That’s a good observation. Pam?

Judy: We’ve talked that one over before.

Aponte: That’s true?

Pam: Sometimes, depending on what mood I’m in. You know, sometimes I’ll say, “Oh, Ma, how was your day?” Just whatever.

Aponte: You know, we don’t have time and I wish we did because I like the way this is going. This is going well. But there is a piece in this that you’ve got to do or this won’t work, and I am not sure what it is, but let me throw something out to you. My thought is this, and it’s just sort of a general idea. That if you were in effect to say to Pam, “Pam, if

you’re not cooperative, if you’re not more civil with your mom, don’t come hugging on me?”

Adrian: It’s been tried. It’s been done.

Aponte: And?

Adrian: She stayed away from me for a long time.

Aponte: And? What happened?

Adrian: She started being nicer to her mother, and then she came back to me. She had to go to her mother first.

Aponte: Well, then you got it. You’ve got the formula.

Adrian: There isn’t too much that I didn’t try.

Aponte: Wait a minute. You got the formula. Let me tell you what happens with kids. What happens with kids is that they will respond to the things that we do. But then when we slack off, they go back to the old stuff. So, if you are going to do something and it works, you’ve got to stay with it. If you stay with it, it will work. I think you already know what will work. So all I’m saying to you right here is if you do what already worked and Judy does this new thing, you are going to have a better balance at home.

Adrian: Again, this is communicating between the three of us. Her and I, Judy and Pam, me and Judy. But the whole problem is, it happened today, and I don’t even remember what it was, but I said something to her.

Aponte: To whom now?

Adrian: To Pam. Judy wasn’t home yet. I said something to Pam, and you could tell in the tone that she used that she was angry, and she walked away, and she was already in the hallway mumbling her anger, and I turned around and I hollered at her, and says, “You’re talking like your mother, and I can’t hear you. Maybe I’m going deaf, but I can’t hear you. You’re mumbling like your mother does.”

Judy: Go ahead, and?

Adrian: So, she went into the kitchen and started mumbling some more, and I said it again, and then she said something out loud. I don’t

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even remember what the words were now, but I can remember the incident.

Aponte: Right.

Adrian: And I don’t remember what caused it, but this is what I would like to get stopped, is this anger and the mumbling under the breath. You know what I’m saying? This is what I don’t understand.

Aponte: Adrian, look. I hear you. Let me tell you what’s going on. Pam is so used to being a spoiled brat that it is affecting everything that she does at home. Okay? You can’t fix everything at once. I am suggesting that you hold onto one thing and stay with it, and I am suggesting to you that it will work if you do that. And Pam wants you to do that, I think, which is Judy is going to say to Pam, in effect, “Do you want me to be your mother? And if you want me to be the mother I need to have you be an adult. Do you want to be an adult or do you want to be a spoiled brat?” That’s what she’s going to be saying, asking her over and over and over. And if Pam responds like a spoiled brat, Judy says, “Okay, you’ve made your choice.” At the same time, what you’ve already tried and worked, if you stay with that, which is, “Pam, you want to be close to me and affectionate with me? I’ve got to see you treat your mother better than you’re treating her. Because if not, I’m not playing ball.” Just stay with that. I think it will work. And the reason I believe t will work is because Judy really loves this young woman. And Pam is going to have a chance to see what it’s like to have a mother, a mother who has a chance to show her affection. Judy will only have a chance to show her affection if she doesn’t have to compete with you. If Pam experiences the two of you working together to get the right balace here, it will work.

Adrian: I thought we’d been trying. This is what I thought we’d been trying.

Aponte: But, we’ve got something new today.

Judy: Try something new and . . .

Aponte: Okay, but it is going to require that you and Judy work together. Say, “We are not going to let Pam play one off against the other. We are not going to let Pam treat Dad like he’s great and mom’s

just a nasty old lady here”. And this is what Pam wants, right Pam? Am I right?

Pam: I want both of them to like me.

Aponte Commentary: Pam gets it! She declares herself ready to relate to her parents as a team, without needing to play favorites. The therapist affirms Pam’s new position vis-à-vis her parents.

Aponte: They are both going to like you. That’s what we are talking about.

Adrian: We both love you.

Aponte: That’s the point. And this is your chance to get them both to love you instead of just having one to love you.

Pam: Okay, I see.

Aponte: Okay? So, they will work together to try to get this balanced out, so you feel like “I’m close to my dad and I’m close to my mom, and at the same time I can finally stop being a spoiled brat. I can finally grow up.” Are you with me, Pam? You know what I would like to you to do, Pam? I would like you to reach out with each hand and grab your mom’s hand and your dad’s hand at the same time.

Aponte Commentary: The therapist continues to work to make the experience real, intensifying it. He asks Pam to take the initiative and grab each of her parents’ hands, pledging in action her new relationship with them. Remarkably, she falls into her mother’s arms after doing so, and the father supports the gesture. They were done!

Judy: I love you. Okay.

Pam: Kleenex.

Judy: Thank you.

Aponte: I think you guys have got it if you’ll stay with this. I think you’ll make Pam a very happy young woman. Okay, folks. We are done.

Judy: Thank you.

Aponte: Good work.

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Judy: Thank you.

Aponte: Good work, Adrian.

Adrian: Thank you.

Judy: It was very nice tonight.

Aponte: Pam, good work.

Pam: Thank you.

Judy: We will give it a try.

Aponte: Stop saying that. It is going to work if you stay with it. I’m telling you. It can’t fail.

Judy: Okay.

Video CreditsSpecial Thanks to:

The clients for their time and their courage to share their personal stories so that others may learn.

Graduate students, Barbara Milton and Teresa Hannon, for their dedication to the success of this project.

The faculty and students in the Division of Psychology and Counseling of the College of Education at Governors State University for their participation.

Addison Woodward, Chair, Division of Psychology and Counseling, and Larry Freeman, Acting Dean of the College of Education at the Governors State University for their support, participation and encouragement.

A very special thank you to Judy Fifer, Editor, Allyn & Bacon, for her courage and vision.

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About the ContributorsVIDEO PARTICIPANTSDr. Aponte MSW, LCSW, LMFT is a clinical associate professor in Drexel University’s Couple & Family Therapy Department, a Fellow of the American Association of Marriage and Family Therapy, and a Board Certified Diplomate in Clinical Social Work. He received postgraduate training at the Menninger Clinic and came to Philadelphia to work at the Philadelphia Child Guidance Clinic of which he eventually became the director.Dr. Aponte has published numerous articles on family therapy, training and supervision in therapy, working with people of diverse ethnic, cultural and socioeconomic backgrounds, and spirituality in therapy, in addition to his book, Bread and Spirit: Therapy with the new poor. Among other honors, Dr. Aponte has received the award for Distinguished Contribution to Family Therapy and Practice from the American Family Therapy Academy in 1992, and the award for Outstanding Contribution to the Field of Marriage and Family Therapy from the Association for Marriage and Family Therapy in 2001.Jon Carlson, PsyD, EdD, Host, is Professor of Psychology and Counseling at Governors State University and a practicing clinical psychologist. He has authored 40 books and 150 journal articles, and developed over 200 videos featuring leading experts in psychotherapy, substance abuse treatment, and parenting and couples education.DianeKjos,PhD,Host,now retired, was a professor at Governors State University in Illinois for 22 years, and past president of both the Illinois Counseling Association and the National Career Development Association. She is co-author, with John Carlson, of two textbooks— Theories of Family Therapy and Becoming an Effective Therapist—and co-host of the video series Psychotherapy with the Experts, Family Therapy with the Experts, and Brief Therapy Inside-out.

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MANUAL AUTHORSAli Miller, MA, MFT, is a psychotherapist in private practice in San Francisco and Berkeley, CA. She works with individuals and couples and facilitates therapy groups for women. You can learn more about her practice at www.AliMillerMFT.com.

More Psychotherapy.net Videos We have videos covering a wide range of experts, approaches, therapeutic issues and populations. We continually add new titles to our catalogue. Visit us at www.psychotherapy.net or call (800) 577-4762 for more information.ApproachesAdlerian Therapy Integrative TherapyArt Therapy Motivational TherapyBody-Oriented Therapy Multicultural TherapyBrief Therapy Narrative TherapyChild Therapy Object Relations TherapyCognitive Behavioral Therapy Person-Centered TherapyConsultation/ Supervision Positive PsychologyCouples Therapy PsychodramaExistential-Humanistic Therapy Psychodrama TherapyFamily Therapy/ Family Systems REBTGestalt Therapy Solutions-Focused TherapyGroup Therapy

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